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Rvcren <br />�e <br />CITY ENGINEEflS <br />EVERETT, WASHINGTON <br />The Undersigned <br />�'�reby applies tor permission to <br />At the lollowing location__ <br />SKET�N --_. _ ---- <br />(Work to bc dnne� <br />� <br />APPLICATION F�OR RIGHT-OF�WAY USE PERMIT <br />i . <br />i� ��i. 'r� % <br />-- �--�-----'�'-- <br />DRIVEWAY SECTION <br />NO SCALE <br />� i <br />�__.—�1'_L.IP _- __ � <br />i 3o'y 1 _ _- �30 � <br />CUPYUI I1�1`,���PPLU..:l�III)I�J III <br />I BF POSTED ON JOBSITE. I <br />i i'.Al L EN(31N[f_RING UEPT. 259�Hitt t� <br />!�1 Ili;i iic': P.( I-(1Rf: CnNSTRUCTI[lfli <br />CHECK LIST <br />Water Valve <br />Diainage <br />Cw6 & Guttr.r <br />Sidewalk _ � <br />Intper.tor's Siynature <br />Uair � <br />Rcrnaiks � - — <br />PEFiMIT NO.._ <br />7hc UnderSiqn�•�� rn:iu�i Ii��mLy ay�rrs Io h ilil nnd <br />5nvo ha�mles5 �hu City uf L vmvlt hum ;iny onJ dll <br />claims for damages that may arise becaum nl im,talid <br />tion and mainlenance ol Ihe improvement heirtu <br />applied for and (urther agrees to remove same upon <br />notir.e from Ihe City and to replace public property <br />damaGed Ihereby. <br />Siynature of ApPlicant �� � <br />, <br />i" <br />'— ' � `�/- . J,i '-� r, <br />Address <br />� <br />Telephonr. Number <br />� , �r . <br />_.—.___ _ . ___-___--.-- <br />fee <br />Dept. Approvals <br />Enginecrs. _ _ <br />Ware:------------ — <br />Sireet <br />Communications <br />Traffic <br />Approved by � <br />Datr APp�oved <br />